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Voluntary assisted dying via telehealth is another step down a perilous path

  • 10 June 2021
In legislatures around Australia at present euthanasia is a staple item. Apart from the moves to legalise it in Queensland and South Australia, Justice Party MP Stuart Grimley has proposed amendments to the Victorian law. It would give regional Victorians the option to use the euthanasia services to end their lives through telehealth.

Critics of the amendment have claimed that it is unreasonable to make euthanasia more widely available when palliative care services are still critically lacking in regional Victoria. They cite the recommendation of the Royal Commission into Aged Care Quality and Safety that dementia care and palliative care ought to be the core business of aged care. It is vital that euthanasia legislation ought to balance the liberty of the invulnerable against the safeguarding of the vulnerable, especially the elderly and people with disabilities.

In considering the amendment it will be helpful to consider two common arguments in support of euthanasia. First, that it would enhance individual autonomy or self-determination. This argument, which featured prominently in the submissions to the 2016 Victorian Parliament Inquiry into End of Life Care is often played as the trump card in the euthanasia debate. The second argument, central to the advocacy of Drs Philip Nitschke and Rodney Syme, is that euthanasia provides relief for people with existential suffering that palliative care cannot adequately offer.

The principle of respect for individual autonomy was introduced into health ethics with the Nuremberg code (1947) in response to the need to safeguard the vulnerable from abuse at the hands of health professionals. The Nuremberg code ushered in a new era, in which the vulnerability caused by the power imbalance that exists between the physician and the patient has become the major concern in health ethics. The Nuremberg code has restricted the power of physicians by making it compulsory for them to obtain informed consent from the participant before making any medical intervention, be it in health practice or in research involving human subjects.

The principle of respect for autonomy in health ethics is formulated to address this power imbalance. Its aim is to safeguard the vulnerable from abuse by empowering the vulnerable and simultaneously restricting the power of the physician.

Seventy years after Nuremberg, in Australia safeguarding the vulnerable has become mandatory in virtually every sphere of social interaction: safeguarding children against abuse, safeguarding women against abuse and harassment in the workplace and in the home, safeguarding LGBTQI children against discrimination,